Provider Demographics
NPI:1902143175
Name:LUMEN COUNSELING, INC.
Entity Type:Organization
Organization Name:LUMEN COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:LAMOUREUX
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:904-448-5521
Mailing Address - Street 1:6034 CHESTER AVENUE
Mailing Address - Street 2:SUITE 119
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2266
Mailing Address - Country:US
Mailing Address - Phone:904-448-5521
Mailing Address - Fax:904-448-5524
Practice Address - Street 1:6034 CHESTER AVENUE
Practice Address - Street 2:SUITE 119
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2266
Practice Address - Country:US
Practice Address - Phone:904-448-5521
Practice Address - Fax:904-448-5524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6823251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health